Stanford Research Institute is collaborating with Lockheed Missiles and Space Company and Kaiser Medical Center to study the problem of non-adherence to hypertension care. The objectives of this project are: (1) to identify those characteristics of hypertensive subjects that predict adherence behavior, (2) to determine the main effects and synergistic interactions of six complementary interventions in reducing non-adherence at all stages of hypertension care; and (3) to determine whether increased effectiveness, including cost-effectiveness result from tailoring interventions to match patient characteristics. We are in the second year of a three year study. Two achievements can be highlighted: (1) A carefully worked-out three-stage screening process that optimizes the referral process; (2) A carefully designed communications effort to increase the volunteer rate so that the problem of self-selection would be minimized. Preliminary results from the first year show that 1189 subjects were screened; 98 were already under care for hypertension; 27 subjects so far have been referred to care. The most significant achievement of the current year's effort is the establishment of what amounts to a new mode of hypertension care, in which an industrial setting has in effect been turned into an outreach arm of a health maintenance organization. This innovation in health care has great promise in optimizing high blood pressure education and control.